Three spine surgeons answer these questions:
Do you think the future is bright or dark for spine surgery?
What are the biggest factors driving decision-making for your practice today?
Isador Lieberman, MD. Texas Back Institute (Plano): Very bright for clinical care of the spine patient. We are in a very privileged position at this time. There is so much technology within our reach that can help our patients; we just need to figure out how to make it work best for them.
Cost of care and contracting because more and more the insurers are denying appropriate interventions in an effort to discourage those who try to 'game the system'; this only serves to further escalate the efforts of those who do take advantage, and also denies the care to legitimate patients served by ethical practitioners.
Alok Sharan, MD. Westmed Spine Center (Yonkers, N.Y.): The future is bright for spine surgery. As the population ages I predict there will be a greater need for appropriate spine surgery in the elderly population. As the research on who benefits from spine surgery becomes clearer, it will become easier to direct patients toward surgery sooner. So many times I have seen an elderly patient come to me with symptomatic spinal stenosis. They are in reasonable physical condition. We send them for pain management/epidural injections and due to their pain, they become deconditioned over time.
For an individual like that, as long as we could do surgery safely, taking them to the operating room sooner rather than later would result in a greater overall outcome and perhaps prevent them from becoming deconditioned. From a resource perspective, preventing that elderly individual from becoming deconditioned would lead to decreased utilization of resources over the entire episode of care.
In our practice, while we are focused on performing appropriate spine surgery and achieving the best outcomes for our patients, we do keep an eye on the overall utilization of resources to ensure that we are being efficient in how we deliver overall spine care.
Scott Boden, MD. Emory Orthopaedics & Spine Center (Atlanta): I think the future of spine surgery is bright. The right operation in the right patient can restore function in very measurable ways. While there is a continued focus on minimally invasive approaches, the choice of operation and patient diagnosis will always be paramount to success. My hope is that artificial intelligence and new diagnostics will help stratify patients more clearly into treatment groups.
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For a deeper dive into the future of spine, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.